CAJ | 학술논문

目的研究B细胞在狼疮肾炎患者肾组织的浸润情况,探讨 B细胞浸润与狼疮肾炎肾组织病理改变的关系及临床意义.方法收集119例处于活动期的狼疮肾炎患者肾组织标本.应用免疫酶组织化学方法检测肾组织中B细胞的浸润情况,根据浸润程度分为5级.统计分析采用两独立样本t检验和x2检验.结果 ①119例狼疮肾炎中有B细胞浸润62例(52.1%).B细胞主要浸润于肾间质组织,多见于Ⅳ型狼疮肾炎患者,Ⅴ型少见.②狼疮肾炎肾组织中B细胞浸润同无浸润组比较肾组织活动指数及慢性指数显著升高,差异有统计学意义;B细胞浸润组同无浸润组的血尿素氮水平比较[(12±9)与(6±3)mmol/L]、血清肌酐水平[(105±84)和(61±21)μmol/L](P＜0.01).③狼疮肾炎肾组织中以IgC型抗体荧光强度最强;B细胞浸润组与无B细胞浸润组间各亚型抗体沉积率比较差异无统计学意义(P均＞0.05).结论狼疮肾炎中伴有肾组织B细胞浸润的患者病变重于无B细胞浸润者,局部B细胞可能以非抗体生成细胞的方式参与狼疮肾炎病变.
목적 연구B세포재랑창신염환자신조직적침윤정황,탐토 B세포침윤여랑창신염신조직병리개변적관계급림상의의.방법 수집119례처우활동기적랑창신염환자신조직표본.응용면역매조직화학방법검측신조직중B세포적침윤정황,근거침윤정도분위5급.통계분석채용량독립양본t검험화x2검험.결과 ①119례랑창신염중유B세포침윤62례(52.1%).B세포주요침윤우신간질조직,다견우Ⅳ형랑창신염환자,Ⅴ형소견.②랑창신염신조직중B세포침윤동무침윤조비교신조직활동지수급만성지수현저승고,차이유통계학의의;B세포침윤조동무침윤조적혈뇨소담수평비교[(12±9)여(6±3)mmol/L]、혈청기항수평[(105±84)화(61±21)μmol/L](P＜0.01).③랑창신염신조직중이IgC형항체형광강도최강;B세포침윤조여무B세포침윤조간각아형항체침적솔비교차이무통계학의의(P균＞0.05).결론 랑창신염중반유신조직B세포침윤적환자병변중우무B세포침윤자,국부B세포가능이비항체생성세포적방식삼여랑창신염병변.
Objective To investigate B-cell distribution in lupus nephritis and evaluate its significance in pathological classification.Methods Kidney biopsy specimens were obtained consecutively from 119 patients with LN, B lymphocytes distribution were detected using immunohistochemical staining with specific antibodies and were classified into 5 groups.Chi-square test and t test were used for statistical analysis.Results ①B lymphocytes infiltration occurred in 52.1% of the LN patients (62/119), B lymphocytes were mainly distributed in the renal interstitial tissue, which occurred most frequently in class Ⅳ LN but rare in class Ⅴ LN. ②B-cell infiltrating group was associated with active disease presentations and chronic indices P＜0.01). Blood urea nitrogen(BUN)[(12±9) vs (6±3) mmol/L] and serum creatinine(Cr)[(105±84) vs(61±21) μmol/L] were higher in B-cell infiltrates group than non-B-cell infiltration group (all P＜0.01). ③Kidney biopsy specimens showed predominantly IgG deposit in immune-fluorescency intensity examination.The Ig subtype which deposited in B-cell infiltrating group was not statistically different from those deposited in non-B cell infiltrating group (P＞0.05). Conclusion This study has shown that renal B cell infiltration occurs in 52.1% of the LN patients.Patients with renal B cell infiltration have more severe kidney tissue injury and poorer renal outcomes than patients without B cell infiltration. Renal B lymphocytes infiltration may contribute to the pathogenesis of LN in a non-antibody-secreting way.